How does mpox spread? What are the instructions for treating mpox disease in humans in Vietnam?
Vietnam: How does mpox spread?
According to Part II of the Guidelines for the prevention of mpox infection in healthcare facilities in Vietnam, issued with Decision 2306/QD-BYT in 2022, mpox can be transmitted through the following routes:
(1) Transmission from animals to humans:
Through the secretions of infected animals, including respiratory droplets or contact with secretions from wounds.
(2) Transmission from person to person:
- Transmission can occur through close and prolonged contact with an infected person, including respiratory droplets during face-to-face contact or direct contact with the skin lesions of the infected person and contaminated objects.
- Transmission from mother to fetus can occur through vertical transmission.
- Transmission can occur through sexual or intimate contact, either through direct contact with mpox lesions or direct contact with respiratory secretions of an infected person.
(3) Transmission from contaminated environment to humans:
- Infection can occur through contaminated clothing, bedding with particles of contaminated skin.
- Inhaling particles of contaminated skin in the air or coming into contact with sensitive areas of the body, such as non-intact skin or mucous membranes.
How does mpox spread? What are the instructions for treating mpox disease in humans in Vietnam? (Image from the Internet)
What are the instructions for treating mpox disease in humans in Vietnam?
Pursuant to the provisions in Section 3 of the Instructions issued together with Decision 2306/QD-BYT in 2022, instructions for treating mpox disease in humans are as follows:
Principles of treatment of mpox disease:
- Carry out surveillance and isolation of suspected/confirmed cases;
- Symptomatic treatment is mainly;
- Ensure nutrition, electrolyte balance and psychological support;
- Use specific treatment drugs in severe cases and special conditions (newborns, the elderly, immunocompromised people, etc.) according to recommendations of the World Health Organization and regulations of Vietnam.
- Monitor, detect and promptly treat serious conditions and complications of the disease.
Specific treatment of mpox disease:
- General treatment measures
+ Isolate at medical facilities suspected/confirmed cases according to the Ministry of Health's temporary guidance on monitoring and preventing mpox disease.
+ Individualize treatment for each patient.
- Mild form:
Treat symptoms such as:
+ Reduce fever, reduce pain.
+ Care for damaged skin, eyes, mouth.
+ Ensure nutrition and electrolyte balance.
+ It is necessary to monitor and detect complications early, if any: pneumonia, skin infections, septicemia, encephalitis... for treatment in the isolation room in the recovery department.
+ Prevent and control infections according to regulations
- Severe form:
Need treatment in an isolation room in the resuscitation department, treatment of complications (if any) according to issued protocols
- Specific treatment drugs:
+ Indication
++ People with severe complications (sepsis, pneumonia, encephalitis...).
++ People with immunodeficiency (HIV, cancer, being treated with immunosuppressive drugs or high doses of corticosteroids...).
++ Children, especially children under 8 years old.
++ Women who are pregnant or breastfeeding.
++ People with progressive acute illness.
+ Treatment drugs used according to recommendations of the World Health Organization (refer to Appendix 2)
++ Tecovirimat
++ Cidofovir
++ Brincidofovir
++ Intravenous immunoglobulin
What are prevention measures for mpox in Vietnam?
Pursuant to Chapter IV of the Guidelines issued with Decision 2306/QD-BYT in 2022, include the following:
Non-specific preventive measures:
- Avoid close contact with individuals suspected or confirmed with mpox, and avoid direct contact with their wounds, body fluids, droplets, and contaminated objects..
- Cover the mouth and nose when coughing or sneezing, preferably with a cloth or tissue or disposable tissue or sleeve to reduce the spread of respiratory secretions; wash hands with soap and clean water or use hand sanitizer immediately after coughing or sneezing. Avoid spitting in public places.
- Regularly wash hands with soap and clean water or use hand sanitizer.
- Individuals with acute rash symptoms of unknown cause accompanied by one or more suspicious symptoms should proactively contact healthcare facilities for monitoring and timely advice. They should also self-isolate and avoid close contact with others, including sexual contact.
- Individuals traveling to countries/territories with circulating mpox (Central and West Africa) should avoid contact with mammals (dead or alive), such as rodents, marsupials, primates, which could potentially harbor the mpox virus. Upon returning to Vietnam, they should proactively report to local health authorities for advice.
- Ensure food safety; adopt a healthy lifestyle, increase physical activity, and improve health.
- Healthcare personnel caring for individuals suspected or confirmed with mpox should use appropriate personal protective equipment (PPE).
Specific preventive measures:
The results of some studies have shown that the previously available smallpox vaccine has some efficacy in preventing mpox. Currently, a few countries have approved the use of the new generation (generation 2, 3) of smallpox/mpox vaccines for prevention and control of mpox.
As of July 18, 2022, the World Health Organization (WHO) does not recommend widespread vaccination against mpox; vaccination is only recommended for high-risk individuals such as healthcare workers, individuals with direct contact with cases, and vaccination decisions should be made on a case-by-case basis after exposure to a case. Research on the effectiveness of mpox vaccines is still ongoing.
Border health quarantine:
Implement the regulations specified in Government Decree 89/2018/ND-CP on detailed provisions for the implementation of certain articles of the Law on Prevention and Control of Infectious Diseases regarding border health quarantine, and follow the directives of the Government and guidelines from the Ministry of Health.
Isolation and health management at border checkpoints should comply with the regulations specified in Government Decree 101/2010/ND-CP on detailed provisions for the implementation of certain articles of the Law on Prevention and Control of Infectious Diseases regarding the application of health isolation measures, compulsory health isolation, and control of specific epidemics during outbreaks, as well as follow the directives of the Government and guidelines from the Ministry of Health.
Recommendations for passengers to self-monitor their health for 21 days after entry, limit contact, and avoid crowded places. If symptoms such as rash, headache, fever, chills, sore throat, discomfort, fatigue, and lymphadenopathy occur, they should limit contact with others and seek advice, diagnosis, and treatment at the nearest healthcare facility.
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